摘要
目的探讨急性大血管闭塞性脑卒中患者载脂蛋白E(ApoE)基因单核苷酸多态性及其与血管内治疗后预后的关系。方法选择行血管内治疗的100例急性大血管闭塞性脑卒中患者,根据术后90 d时患者改良Rankin评分量表(mRS)得分情况,分为预后良好组(mRS≤3分,n=66)与预后不良组(mRS>3分,n=34)。比较两组受试者的基线资料、免疫指标,检测ApoE基因多态性,记录术后出血情况。结果预后不良组高龄患者比例高于预后良好组(P<0.05)。预后不良组外周血甘油三酯(TG)、N末端B型钠尿肽原(BNP)、D-二聚体(D-D)均高于预后良好组(P<0.05)。两组ApoE基因表型均以ε3/ε3占比为最高,且预后良好组ε3/ε3占比高于预后不良组(77.27%vs 55.88%,P<0.05);两组其他基因表型未见明显差异(P>0.05)。预后良好组和预后不良组ApoE基因频率均以ε3型占比最高,分别为87.12%和76.47%;但两组间ε2、ε3、ε4型比较,差异均无统计学意义(P>0.05)。结论急性大血管闭塞性脑卒中血管内治疗后预后不良以高龄患者多见,ApoE基因表型以ε3/ε3居多,可能是血管内治疗后预后良好的保护因素;ApoE基因频率以ε3型居多,但与血管内治疗后预后无明显相关性。
Objective To explore the single nucleotide polymorphism of apolipoprotein E(ApoE)gene in patients with acute large vessel occlusive stroke and its relationship with prognosis after endovascular treatment.Methods 100 patients with acute large vessel occlusion stroke who chose endovascular treatment were selected,and divided into the good prognosis group(mRS score≤3,with 66 cases)and the poor prognosis group(mRS score>3,with 34 cases)based on the modified Rankin Scale(mRS)score 90 days after surgery.The baseline data and immune indicators between 2 groups were compared,ApoE gene polymorphism was detected,and postoperative hemorrhage were record.Results The proportion of the elderly patients in the poor prognosis group was higher than that in the good prognosis group(P<0.05).The level of triglyceride(TG),N-terminal B-type natriuretic peptide precursor(BNP),D-dimer(D-D)of the poor prognosis group were higher than those in the good prognosis group(P<0.05).ApoE gene phenotypes in the 2 groups were predominantly represented byε3/ε3,and the proportion ofε3/ε3 in the good prognosis group was higher than that in the poor prognosis group(77.27%vs 55.88%,P<0.05).There was no statistical difference in other gene phenotypes between the 2 groups(P>0.05).The ApoE gene frequency ofε3 type were both highest in the good prognosis group and the poor prognosis group,accounting for 87.12%and 76.47%respectively,yet there was no statistical significant difference in the comparison ofε2,ε3,andε4 types between the 2 groups(P>0.05).Conclusion The poor prognosis of acute large vessel occlusion stroke after endovascular treatment is more common in elderly patients,and the ApoE gene phenotype is mostlyε3/ε3,which may be protective factor for good prognosis after endovascular treatment.The frequency of ApoE genes is mostlyε3,but there is no significant correlation with the prognosis after endovascular treatment.
作者
李俊杰
唐灵
朱佳佳
LI Junjie;TANG Ling;ZHU Jiajia(Department of Neurology,Nanfang Hospital,Southern Medical University,Guangzhou 510000,China)
出处
《新疆医科大学学报》
CAS
2024年第10期1354-1358,共5页
Journal of Xinjiang Medical University
基金
广东省自然科学基金项目(2018A030313792)。
